Surgical treatment for Hirschsprung’s Disease: An ERNICA animation for parents and families

Hirschsprung's disease is also known as agangliosis of the colon

Surgical removal of the affected part is usually performed 2 to 3 months after diagnosis, when the baby is strong enough and growing well

Surgery is performed when there are no signs of enterocolitis (inflammation of the bowel)

The aim of surgery is to remove the aganglionic bowel, which is the affected part of the bowel with no ganglion cells present

The transition zone should be removed, which is the area of the bowel between the aganglionic part and the part containing a normal amount of ganglion cells (ganglionic bowel)

The remaining part of the bowel is connected to the anal canal in a pull-through procedure to restore the movement of feces

During the operation, tissue samples can be taken to confirm the presence of ganglion cells

The procedure used to be done by open surgery with a large incision in the outside skin

Nowadays, when possible, the procedure is done transanally (via the anal canal), sometimes assisted by laparoscopy

Different pull-through techniques include the transanal pull-through technique and the Swenson, Duhamel, and Soave procedures

The surgical techniques used depend on the child, the length of the affected bowel area, the surgeon's preference, and hospital resources

Preservation of the anal canal is crucial in order to maintain continence

After surgery, it is important that the new connection between the bowel and anal canal is unobstructed and that surgical wounds heal well

After surgery, developing babies may experience ongoing difficulties including constipation (difficulty passing feces) and lack of control over bowel movements

Sometimes support with bowel management is necessary after surgery

After surgery, individuals with Hirschsprung's disease may remain prone to bowel infections known as enterocolitis

Structured regular follow-up care by a multidisciplinary team (MDT) of different clinical specialists is essential for babies with Hirschsprung's disease

Identifying any complications or difficulties early is very important

Symptoms after corrective surgery can improve as children grow older